Paid Registration/Donation Form



Product:  SmartDir



Transaction:                Purachase                Donation
(please circle one)         (min. $10)               (any amount accepted)



Amount enclosed:  ____________________________________



Disk Size:           5.25             3.5



Name     __________________________________________________


Address  __________________________________________________


         __________________________________________________


         __________________________________________________


Phone    (_____) _____ - _____



Please mail to:

Owen Emry
302 North Jefferson Street
Arlington, Virginia